Cardiogenic Shock STEMI Tachycardia 
Dr. Smith's ECG Blog
OCTOBER 26, 2010
He was rushed by residents into our critical care room with a diagnosis of STEMI, and they handed me this ECG: There is sinus tachycardia with ST elevation in II, III, and aVF, as well as V4-V6. At first glance, it seems the patient is having a STEMI. Then ACS (STEMI) might be primary; this might be cardiogenic shock.
Dr. Smith's ECG Blog
FEBRUARY 16, 2020
A previously healthy 53 yo woman was transferred to a receiving hospital in cardiogenic shock. Here was the ECG: There is sinus tachycardia. So Shark Fin really is just a dramatic representation of STEMI, and can be in any coronary distribution. So this is STEMI, right? This was sent by a reader. and K was normal.
Dr. Smith's ECG Blog
NOVEMBER 16, 2010
Here are more examples of wide complex tachycardia: these are all a mix of ventricular tachycardia and SVT with aberrancy. He was in cardiogenic shock. There is tachycardia, and there is a wide complex. This wide complex tachycardia could easily be misdiagnosed as V tach.
Dr. Smith's ECG Blog
SEPTEMBER 5, 2024
Sinus tachycardia has many potential causes. This is especially true for the elderly patient with sinus tachycardia. What is the cause of the sudden tachycardia? The VSR is what is causing the cardiogenic shock! She had a very elevated troponin T at 12,335 ng/L at the time of presentation.
Dr. Smith's ECG Blog
SEPTEMBER 23, 2024
The conventional machine algorithm interpreted this ECG as STEMI. It shows sinus tachycardia with right bundle branch block. Taking a step back , remember that sinus tachycardia is less commonly seen in OMI (except in cases of impending cardiogenic shock). When EMS found her, she was dyspneic and diaphoretic.
Dr. Smith's ECG Blog
OCTOBER 1, 2024
when the usual negative P wave deflection of sinus tachycardia is nowhere to be found in lead V1 )? While of course possible for the rhythm in ECG #1 to be either AFlutter or fascicular VT — sinus tachycardia immediately becomes a much more likely possibility once we know that this patient is critically ill with multisystem disease.
Dr. Smith's ECG Blog
AUGUST 13, 2020
Because of the tachcardia, I would expect her to be very poor left ventricular function and maybe Cardiogenic shock. Still Irregular Blood pressure during these rhythms was adequate; there was no shock. The patient spontaneously converted back to sinus tachycardia. Later, I obtained more clinical history.
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